Acute Sore Throat

Acute sore throat

Avoid antibiotics as 90% resolve in 7 days without, and pain only reduced by 16 hours.

Use FeverPAIN Score: Fever in last 24h, Purulence, Attend rapidly under 3d, severely Inflamed tonsils, No cough or coryza). 

Score 0-1: 13-18% streptococci, use NO antibiotic strategy;
2-3: 34-40% streptococci, use 3 day back-up antibiotic;
>4: 62-65% streptococci, use immediate antibiotic if severe, or 48hr short backup prescription.

Always share self-care advice & safety net.
Antibiotics to prevent Quinsy NNT >4000.
Antibiotics to prevent Otitis media NNT 200.
10d penicillin lower relapse vs 7d in ​<18yrs.


500mg QDS or 1G BD (QDS when severe) child dose

10 days

Penicillin Allergy: clarithromycin

250-500mg BD child dose

5 days